The Curbsiders Internal Medicine Podcast REBOOT #326 NephMadness 2022: Cardiorenal Syndrome
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Aug 19, 2024 
Join kidney specialist Dr. Joel Topf, known for his nephrology expertise, and heart specialist Dr. Sadiya Khan, who focuses on cardiovascular health, as they dive into the complexities of cardiorenal syndrome. They discuss managing the 'creatinine bump' during treatment, explore the use of SGLT-2 inhibitors, and tackle the challenges of diuretic resistance. Their insights on monitoring cardiac biomarkers in chronic kidney disease patients add depth, emphasizing the intertwined nature of heart and kidney health.
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Venous Pressure Drives Cardiorenal Syndrome
- Cardiorenal syndrome reflects the bidirectional interaction where heart dysfunction causes kidney issues and vice versa.
- Increased venous pressure, rather than decreased cardiac output, often explains impaired kidney function in heart failure.
Manage Creatinine Rise Confidently
- Avoid withholding diuretics due to fear of creatinine rise in volume-overloaded heart failure.
- Treat the volume overload aggressively to improve heart and kidney function.
Creatinine Rise Can Be Hemodynamic
- A rising creatinine during diuresis does not necessarily imply kidney injury.
- Volume removal concentrates creatinine, causing a lab bump despite clinical improvement.